WILLPOWER MELTDOWN SOMETIMES

As the director of a stroke center at a rural hospital, I have always considered generating revenue to be important. One way to accomplish this is by participating in clinical trials and enrolling patients. During my three years as director, we have participated in two clinical trials. The first trial met its enrollment target, but we have only managed to enroll about half the required number for the second trial, which is ongoing. I have been the primary physician for all patients so far. The trials target patients with acute ischemic stroke who are in the early stages, have moderate symptoms, and are not undergoing surgical treatment. In reality, the number of patients fitting these criteria is small. Considering who might benefit, I question the value of targeting super-elderly patients in their 80s or 90s, so I seek younger individuals who seem likely to maintain independent living. This time, the patient was a woman in her 60s whose risk factor was poorly controlled diabetes. Due to rising medical costs, it seems that more people are unable to afford the necessary preventive medications. Even in this rural area, more people appear to be facing the problem of being unable to pay their medical bills.